scholarly journals Evaluating for a correlation between osteopathic examination and ultrasonography on thoracic spine asymmetry

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Shirley Chang ◽  
Jason Maddox ◽  
Erich Berg ◽  
Karen Kim ◽  
Scott Messier ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Thoracic Spine ◽  
Spinous Process ◽  
Vertebral Rotation ◽  
Structural Examination ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Bony Landmarks ◽  
Somatic Dysfunction ◽  
Interexaminer Reliability

Abstract Context The thoracic spine is a common area of focus in osteopathic manipulative medicine (OMM) for a variety of conditions. Thoracic spine somatic dysfunction diagnosis is achieved by palpating for asymmetry at the tips of the transverse processes (TPs). Previous studies reveal that instead of following the rule of threes, the TPs of a given thoracic vertebra generally align with the spinous process (SP) of the vertebra above. Ultrasonography has been widely utilized as a diagnostic tool to monitor musculoskeletal conditions; it does not utilize ionizing radiation, and it has comparable results to gold-standard modalities. In the case of thoracic somatic dysfunction, ultrasound (US) can be utilized to determine the location of each vertebral TP and its relationship with the SP. Previous studies have investigated the correlation between OMM and ultrasonography of the cervical, lumbar, and sacral regions. However, there has been no study yet that has compared osteopathic structural examination with ultrasonographic examination of the thoracic vertebral region. Objectives To examine the relationship between osteopathic palpation and ultrasonographic measurements of the thoracic spine by creating a study design that utilizes interexaminer agreement and correlation. Methods The ClinicalTrials.gov study identifier is NCT04823637. Subjects were student volunteers recruited from the Midwestern University (MWU)—Glendale campus. A nontoxic, nonpermanent marker was utilized to mark bony landmarks on the skin. Two neuromusculoskeletal board-certified physicians (OMM1, OMM2) separately performed structural exams by palpating T2–T5 TPs to determine vertebral rotation. Two sonographers (US1, US2) separately scanned and measured the distance from the tip of the SP to the adjacent TPs of the vertebral segment below. Demographic variables were summarized with mean and standard deviation. Interexaminer agreement was assessed with percent agreement, Cohen’s Kappa, and Fleiss’ Kappa. Correlation was measured by Spearman’s rank correlation coefficient. Recruitment and protocols were approved by the MWU Institutional Review Board (IRB). Results US had fair interexaminer agreement for the overall most prominent segmental rotation of the T3–T5 thoracic spine, with Cohen’s Kappa at 0.27 (0.09, 0.45), and a total agreement percentage at 51.5%. Osteopathic palpation revealed low interexaminer agreement for the overall most prominent vertebral rotation, with Cohen’s Kappa at 0.05 (0.0, 0.27), and 31.8%. Segment-specific vertebral analysis revealed slight agreement between US examiners, with a correlation coefficient of 0.23, whereas all other pairwise comparisons showed low agreement and correlation. At T4, US had slight interexaminer agreement with 0.24 correlation coefficient, and osteopathic palpation showed low interexaminer (OMM1 vs. OMM2) agreement (0.17 correlation coefficient). At T5, there was moderate agreement between the two sonographers with 0.44 (0.27, 0.60) and 63.6%, with a correlation coefficient of 0.57, and slight agreement between OMM1 and OMM2 with 0.12 (0.0, 0.28) and 42.4%, with 0.23 correlation coefficient. Conclusions This preliminary study of an asymptomatic population revealed that there is a low-to-moderate interexaminer reliability between sonographers, low-to-slight interexaminer reliability between osteopathic physicians, and low interexaminer reliability between OMM palpatory examination and ultrasonographic evaluation of the thoracic spine.

Learning how to Differ: Agreement and Reliability Statistics in Psychiatry

1995 ◽  
Vol 40 (2) ◽  
pp. 60-66 ◽  
Author(s):  
L. Streiner David
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Weighted Kappa ◽  
The Other ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
The Subject

Whenever two or more raters evaluate a patient or student, it may be necessary to determine the degree to which they assign the same label or rating to the subject. The major problem in deciding which statistic to use is the plethora of different techniques which are available. This paper reviews some of the more commonly used techniques, such as Raw Agreement, Cohen's kappa and weighted kappa, and shows that, in most circumstances, they can all be replaced by the intraclass correlation coefficient (ICC). This paper also shows how the ICC can be used in situations where the other statistics cannot be used and how to select the best subset of raters.

scholarly journals Reproducibility and relative validity of a newly developed web-based food-frequency questionnaire for assessment of preconception diet

BMC Nutrition ◽  
2019 ◽  
Vol 5 (1) ◽  
Author(s):  
L. Salvesen ◽  
E. R. Hillesund ◽  
F. N. Vik ◽  
A. L. Brantsæter ◽  
N. C. Øverby
Keyword(s):  
Correlation Coefficient ◽  
Rank Correlation ◽  
Food Groups ◽  
Cohen’S Kappa ◽  
Food Frequency ◽  
Relative Validity ◽  
Spearman’S Rank Correlation ◽  
Cohen's Kappa ◽  
Spearman’S Rank Correlation Coefficient ◽  
Median Correlation

Abstract Background The importance of diet and nutrition during preconception age is a window of opportunity to promote future parental and transgenerational health. As a sub-study to a large Norwegian study, ‘Diet today – health of tomorrow’, a food-frequency questionnaire (FFQ) was developed to assess diet during the preconception phase in young adults aged 20 – 30 years and in this paper we report the reproducibility and relative validity of this questionnaire. Methods The FFQ was developed from an existing FFQ validated in adolescents. Participants were recruited on social media and at a university. Reproducibility was assessed by comparing the test and retest of the FFQ. Relative validity was assessed by comparing intake measured by the FFQ with a 7-day weighed food record. Energy, nutrients and food intake were used to assess the reproducibility and relative validity of the FFQ. The study applied the Spearman’s rank correlation coefficient, percentage of agreement and Cohen’s Kappa to assess reproducibility and validity. Results There were 32 participants recruited to the study, of which 21 participants completed both the test-retest reproducibility and the relative validation. The test-retest reproducibility had a median correlation coefficient of 0.85 for energy and nutrients, a median Spearman’s rank correlation coefficient of 0.75 and a median Cohen’s Kappa of 0.51 for food groups. The relative validity of the FFQ had a median correlation coefficient of 0.59 for energy and nutrients, a median Spearman’s rank correlation coefficient of 0.54 and a median Cohen’s Kappa of 0.28 for food groups. Conclusion This newly developed FFQ for preconception diet in young adults had a satisfactory test-retest reproducibility and fair relative validity.

scholarly journals Swedish quality registry for caries and periodontal diseases (SKaPa): validation of data on dental caries in 6- and 12-year-old children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tita Mensah ◽  
Sofia Tranæus ◽  
Andreas Cederlund ◽  
Aron Naimi-Akbar ◽  
Gunilla Klingberg
Keyword(s):  
Dental Caries ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Cohen’S Kappa ◽  
Quality Registry ◽  
Cohen's Kappa ◽  
Icdas Ii ◽  
Dental Records ◽  
Electronic Dental Records

Abstract Background The Swedish Quality Registry for caries and periodontal disease (SKaPa) automatically collects data on caries and periodontitis from patients’ electronic dental records. Provided the data entries are reliable and accurate, the registry has potential value as a data source for registry-based research. The aim of this study was to evaluate the reliability and accuracy of the SKaPa registry information on dental caries in 6- and 12-year-old children. Method This diagnostic accuracy study compared dental caries data registered at an examination with dental health status registered in the patient’s electronic dental records, and with corresponding data retrieved from the SKaPa registry. Clinical examinations of 170 6- and 12-year-old children were undertaken by one of the researchers in conjunction with the children’s regular annual dental examinations where the number of teeth were registered, and dental caries was diagnosed using ICDAS II. Teeth with fillings were defined as filled and were added to the ICDAS II score and subsequently dft/DFT was calculated for each individual. Cohen’s Kappa, the intraclass correlation coefficient (ICC), and sensitivity and specificity were calculated to test the agreement of the ‘decayed and filled teeth’ in deciduous and permanent teeth (dft/DFT) from the three sources. Results Cohen’s Kappa of the dft/DFT-values was calculated to 0.79 between the researcher and the patient record, to 0.95 between patient dental record and SKaPa, and to 0.76 between the researcher and SKaPa. Intraclass correlation coefficient (ICC) was calculated to 0.96 between the researcher and the patient journal, to 0.99 between the patient dental record vs. SKaPa, and to 0.95 between the researcher and SKaPa. Conclusion The SKaPa registry information demonstrated satisfactory reliability and accuracy on dental caries in 6- and 12-year-old children and is a reliable source for registry-based research. Trial registration The study was registered in Clinical Trials (www.ClinicalTrials.gov, NCT03039010)

scholarly journals The Questionnaire Survey Method in Medicine on the Example of Treatment Adherence Scales

2021 ◽  
Vol 17 (4) ◽  
pp. 576-583
Author(s):  
Yu. V. Lukina ◽  
N. P. Kutishenko ◽  
S. Yu. Martsevich ◽  
O. M. Drapkina
Keyword(s):  
Correlation Coefficient ◽  
Internal Consistency ◽  
Roc Analysis ◽  
Reference Method ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Validated Questionnaire ◽  
Adherence Scale ◽  
High Consistency ◽  
Spearman’S Correlation

Aim. Development, testing and validation of the original questionnaire “Adherence Scale” (AS) in the PRIORITY and ANTEY observational studies (OS).Materials and methods. The OS PRIORITY assessed adherence to statins in 298 patients with high and very high cardiovascular risk for 3 months. The OS ANTEY assessed adherence to oral anticoagulants in 201 patients with non-valvular atrial fibrillation for 1 year. Adherence was assessed using the original AS questionnaire, for which external validation was performed (with the calculation of the Cohen's Kappa coefficient). The reference methods were the validated questionnaire and direct medical interview. And internal validation was performed (consistency of questions on the AS using Spearman's correlation analysis). The sensitivity, specificity (ROC analysis) and retest reliability of the adherence scale (Cronbach's alpha) were also determined.Results. In the OS PRIORITY Cohen's kappa for the AS and the reference method of direct medical survey was 0.76 (high consistency), and for the AS and the reference method of the validated questionnaire=0.28 (low consistency). High internal consistency of the questionnaire questions (correlation coefficient=0.78, p<0.0001) confirms the internal validity of the adherence scale. Evaluation of the main characteristics of the modified AS in the OS ANTEY showed high consistency between the results of the AS and the validated questionnaire: Cohen's kappa=0.94 (high external validity of the AS). The retest reliability of the AS was 0.76 (Cronbach's alpha). The internal consistency of the questionnaire was confirmed by a strong and statistically significant correlation between the test questions: Spearman's correlation coefficient=0.80, p<0.0001. The sensitivity of the test, determined using the ROC analysis, was 89%, and the specificity was 62%.Conclusion. The developed and tested new original questionnaire (modified version) – the AS – showed high indicators of reliability, validity and sensitivity. This ensures its reliability and ease of use for assessing various types of adherence and determining the leading factors of non-adherence, and also allows its use in scientific studies and clinical practice.

scholarly journals Validation of Prototype Research Software– Infant Prakriti Assessment (PRS-IPA): Inferences from a Cross Sectional Pattern

2020 ◽  
Vol 9 (4) ◽  
pp. 391-395
Keyword(s):  
Correlation Coefficient ◽  
Rank Correlation ◽  
Kappa Coefficient ◽  
Cohen’S Kappa ◽  
Cross Sectional ◽  
Research Software ◽  
Spearman’S Rank Correlation ◽  
Cohen's Kappa ◽  
Spearman’S Rank Correlation Coefficient ◽  
Assessment Questionnaire

Introduction: Prakriti determination in an infant helps to live more healthy and prosperous life by changing their rearing plan accordingly to prevent onset of related disorders in future. Validation under this study was planned to evaluate the agreement between Infant’s Prakriti Assessment questionnaire (IPAQ) and PRS-IPA (Prototype Research Software-Infant Prakriti Assessment), a software for Prakriti assessment in infants. Materials and methods: A cross sectional study was carried out in Sir Sunderlal Hospital BHU and data were analyzed through two step Prakriti determination process i.e. first, by Infant’s Prakriti Assessment questionnaire (IPAQ) and second by PRS-IPA. Validation was done by Spearman’s Rank Correlation Coefficient and Cohen's kappa coefficient. Observations and Result: In this study, Cohen's kappa coefficient was found 0.955 which is highly significant. Prakriti assessed by PRS-IPA software is valid. Validation by Spearman’s Rank Correlation coefficient was also found highly significant (p=0.000). Discussion & Conclusion: The data, derived from spearman’s and kappa suggest its validity and PRS-IPA can be used for the Prakriti assessment with accuracy in infants

scholarly journals An update on image forming methods: structure analysis and Gestalt evaluation of images from rocket lettuce with shading, N supply, organic or mineral fertilization, and biodynamic preparations

2021 ◽  
Author(s):  
Miriam Athmann ◽  
Roya Bornhütter ◽  
Nicolaas Busscher ◽  
Paul Doesburg ◽  
Uwe Geier ◽  
...  
Keyword(s):  
Copper Chloride ◽  
Organic Fertilizer ◽  
Structural Features ◽  
Fertilizer Treatment ◽  
Friedman Test ◽  
Mineral Fertilization ◽  
Cohen’S Kappa ◽  
N Supply ◽  
Cohen's Kappa ◽  
Forming Methods

AbstractIn the image forming methods, copper chloride crystallization (CCCryst), capillary dynamolysis (CapDyn), and circular chromatography (CChrom), characteristic patterns emerge in response to different food extracts. These patterns reflect the resistance to decomposition as an aspect of resilience and are therefore used in product quality assessment complementary to chemical analyses. In the presented study, rocket lettuce from a field trial with different radiation intensities, nitrogen supply, biodynamic, organic and mineral fertilization, and with or without horn silica application was investigated with all three image forming methods. The main objective was to compare two different evaluation approaches, differing in the type of image forming method leading the evaluation, the amount of factors analyzed, and the deployed perceptual strategy: Firstly, image evaluation of samples from all four experimental factors simultaneously by two individual evaluators was based mainly on analyzing structural features in CapDyn (analytical perception). Secondly, a panel of eight evaluators applied a Gestalt evaluation imbued with a kinesthetic engagement of CCCryst patterns from either fertilization treatments or horn silica treatments, followed by a confirmatory analysis of individual structural features. With the analytical approach, samples from different radiation intensities and N supply levels were identified correctly in two out of two sample sets with groups of five samples per treatment each (Cohen’s kappa, p = 0.0079), and the two organic fertilizer treatments were differentiated from the mineral fertilizer treatment in eight out of eight sample sets with groups of three manure and two minerally fertilized samples each (Cohen’s kappa, p = 0.0048). With the panel approach based on Gestalt evaluation, biodynamic fertilization was differentiated from organic and mineral fertilization in two out of two exams with 16 comparisons each (Friedman test, p < 0.001), and samples with horn silica application were successfully identified in two out of two exams with 32 comparisons each (Friedman test, p < 0.001). Further research will show which properties of the food decisive for resistance to decomposition are reflected by analytical and Gestalt criteria, respectively, in CCCryst and CapDyn images.

scholarly journals Prediction of Streptococcus uberis clinical mastitis treatment success in dairy herds by means of mass spectrometry and machine-learning

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexandre Maciel-Guerra ◽  
Necati Esener ◽  
Katharina Giebel ◽  
Daniel Lea ◽  
Martin J. Green ◽  
...  
Keyword(s):  
Machine Learning ◽  
Mass Spectrometry ◽  
Treatment Success ◽  
Clinical Mastitis ◽  
Supervised Machine Learning ◽  
Structural Protein ◽  
Cohen’S Kappa ◽  
Maldi Tof ◽  
Streptococcus Uberis ◽  
Cohen's Kappa

AbstractStreptococcus uberis is one of the leading pathogens causing mastitis worldwide. Identification of S. uberis strains that fail to respond to treatment with antibiotics is essential for better decision making and treatment selection. We demonstrate that the combination of supervised machine learning and matrix-assisted laser desorption ionization/time of flight (MALDI-TOF) mass spectrometry can discriminate strains of S. uberis causing clinical mastitis that are likely to be responsive or unresponsive to treatment. Diagnostics prediction systems trained on 90 individuals from 26 different farms achieved up to 86.2% and 71.5% in terms of accuracy and Cohen’s kappa. The performance was further increased by adding metadata (parity, somatic cell count of previous lactation and count of positive mastitis cases) to encoded MALDI-TOF spectra, which increased accuracy and Cohen’s kappa to 92.2% and 84.1% respectively. A computational framework integrating protein–protein networks and structural protein information to the machine learning results unveiled the molecular determinants underlying the responsive and unresponsive phenotypes.

scholarly journals The accuracy of initial diagnoses in coma: an observational study in 835 patients with non-traumatic disorder of consciousness

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Maximilian Lutz ◽  
Martin Möckel ◽  
Tobias Lindner ◽  
Christoph J. Ploner ◽  
Mischa Braun ◽  
...  
Keyword(s):  
Emergency Care ◽  
Final Diagnosis ◽  
Class I ◽  
Prehospital Emergency Care ◽  
Unknown Etiology ◽  
Care Providers ◽  
Cohen’S Kappa ◽  
Disorder Of Consciousness ◽  
Cohen's Kappa ◽  
Suspected Diagnosis

Abstract Background Management of patients with coma of unknown etiology (CUE) is a major challenge in most emergency departments (EDs). CUE is associated with a high mortality and a wide variety of pathologies that require differential therapies. A suspected diagnosis issued by pre-hospital emergency care providers often drives the first approach to these patients. We aim to determine the accuracy and value of the initial diagnostic hypothesis in patients with CUE. Methods Consecutive ED patients presenting with CUE were prospectively enrolled. We obtained the suspected diagnoses or working hypotheses from standardized reports given by prehospital emergency care providers, both paramedics and emergency physicians. Suspected and final diagnoses were classified into I) acute primary brain lesions, II) primary brain pathologies without acute lesions and III) pathologies that affected the brain secondarily. We compared suspected and final diagnosis with percent agreement and Cohen’s Kappa including sub-group analyses for paramedics and physicians. Furthermore, we tested the value of suspected and final diagnoses as predictors for mortality with binary logistic regression models. Results Overall, suspected and final diagnoses matched in 62% of 835 enrolled patients. Cohen’s Kappa showed a value of κ = .415 (95% CI .361–.469, p < .005). There was no relevant difference in diagnostic accuracy between paramedics and physicians. Suspected diagnoses did not significantly interact with in-hospital mortality (e.g., suspected class I: OR .982, 95% CI .518–1.836) while final diagnoses interacted strongly (e.g., final class I: OR 5.425, 95% CI 3.409–8.633). Conclusion In cases of CUE, the suspected diagnosis is unreliable, regardless of different pre-hospital care providers’ qualifications. It is not an appropriate decision-making tool as it neither sufficiently predicts the final diagnosis nor detects the especially critical comatose patient. To avoid the risk of mistriage and unnecessarily delayed therapy, we advocate for a standardized diagnostic work-up for all CUE patients that should be triggered by the emergency symptom alone and not by any suspected diagnosis.

scholarly journals Classification of Shoulder X-ray Images with Deep Learning Ensemble Models

2021 ◽  
Vol 11 (6) ◽  
pp. 2723
Author(s):  
Fatih Uysal ◽  
Fırat Hardalaç ◽  
Ozan Peker ◽  
Tolga Tolunay ◽  
Nil Tokgöz
Keyword(s):  
Deep Learning ◽  
Performance Test ◽  
The Body ◽  
Test Accuracy ◽  
Cohen’S Kappa ◽  
X Ray ◽  
Cohen's Kappa ◽  
Auc Value ◽  
Magnetic Resonance Imaging Mri ◽  
Fully Connected

Fractures occur in the shoulder area, which has a wider range of motion than other joints in the body, for various reasons. To diagnose these fractures, data gathered from X-radiation (X-ray), magnetic resonance imaging (MRI), or computed tomography (CT) are used. This study aims to help physicians by classifying shoulder images taken from X-ray devices as fracture/non-fracture with artificial intelligence. For this purpose, the performances of 26 deep learning-based pre-trained models in the detection of shoulder fractures were evaluated on the musculoskeletal radiographs (MURA) dataset, and two ensemble learning models (EL1 and EL2) were developed. The pre-trained models used are ResNet, ResNeXt, DenseNet, VGG, Inception, MobileNet, and their spinal fully connected (Spinal FC) versions. In the EL1 and EL2 models developed using pre-trained models with the best performance, test accuracy was 0.8455, 0.8472, Cohen’s kappa was 0.6907, 0.6942 and the area that was related with fracture class under the receiver operating characteristic (ROC) curve (AUC) was 0.8862, 0.8695. As a result of 28 different classifications in total, the highest test accuracy and Cohen’s kappa values were obtained in the EL2 model, and the highest AUC value was obtained in the EL1 model.

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